Management of herpes zoster ophthalmicus varies widely, with some patients being prescribed therapy too late or at suboptimal dosage, an Australian study shows.

Doctors from the Royal Victorian Eye and Ear Hospital in Melbourne analysed data from digital health records on 100 consecutive patients, finding those whose treatment was not started within 72 hours of developing a zoster rash were at increased risk from eye complications. 

Eight of 29 patients who had not started the drugs within the 72-hour window had gone on to develop late complications, such as uveitis and keratitis, compared with 13 of 71 patients (18%) who were treated within the window. 

The findings, published in a research letter in the MJA on Monday, have led eye specialists to stress the importance of consistent guidelines and improved education for doctors.